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SUBMITTED PAPERS
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: RECE11 =D jUN 2 6 2N Permit Number: rJbro'd 11 Building Permit Application St 4 6yNF0 Planning and Development Services 110ie C+ Building and Code Regulation Division 00170e 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERMIT APPLICATION FOR: Building PROPOSED INPROVEMENT LOCATION: Address: 3022 NW Radcliffe Way (ay) C U -?4PGG'O Legal Description: Riverbend Plat Book 67 Page 36 City of Port St. Lucie, St. Lucie County, Florida Property Tax ID #: 442 7Q6CU250006 Site Plan Name: Riverbend Project Name: Riverbend Setbacks Front 40.06 Back: 49.49 Right Side: 15.21 Left Side: 18.88 DETAILED DESCRIPTION OF WORK: New Construction-SFR Model-6811 Elevation C Garaae R 0012- Ex�l2 Lot No.7 Block No. rrumuVuaiwwnwue nwnucu unuei uua penun—uicLn au apply. ZHVAC Gas Tank EJGasPil _ _Shutters Windows/Doors Electric ❑✓_Plumbing Sprinklers Generator 21 Roof Total Sq. Ft of Construction: 4760 Cost of Construction: $ 373,000.00 S Ft. of First Floor: 3635 Utilities:C2Sewer Septic Building Height: _ OWNER/LESSEE: CONTRACTOR: Name Standard Pacific of South Florida Name: Richard Manning Woodley Address:825 Coral Ridge Drive Company: Standard Pacific of South FI GP, Inc. City: Coral Springs State: FL Zip Code: 33071 Fax: 954-434-8840 Phone No.954-232-2290 Address: 825 Coral Ridge Drive City: Coral Springs State: FL Zip Code: 33071 Fax: 954-434-8840 Phone No. 954-232-2290 E-Mail:-Permits@brownspermitting.com Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: Permits@brownspermitting.com State or County License: CBCA17970 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. CERTIFICATION: This application is hereby made to obtain a permit to do the work and installations as indicated, and to obtain a certificate of capacity, if applicable, for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AND AIR CONDITIONERS, FENCES, ETC., not otherwise included with this building permit application. St. Lucie County makes no representation that its granting of a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Homeowner Association rules, bylaws or any covenants that may restrict or prohibit s uch structure. Please consult with your Homeowner's Association and review your deed for any restrictions which may apply. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures (all types), swimming pools, fences, walls, signs, screen rooms, utility substations & accessory uses to another non - residential use. NOTICE TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOBSITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE TO APPLICANT: IF IT IS NOT YOUR RIGHT, TITLE, AND INTEREST THAT IS SUBJECT TO ATTACHMENT: AS A CONDITION OF ISSUANCE OF THIS PERMIT, YOU PROMISE IN GOOD FAITH TO DELIVER A COPY OF THE CONSTRUCTION LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT TO ATTACHMENT. OWNER OR STATE OF FLORIDA COUNTY OF Broward SIGNATURE The foregoing instrument was acknowledged before me this 5 day of SM 20-.5 __, by ( Mr%+z4st-y who is personally known X or has produced as identification. Signature of Notary 'ep•,,, DENISE BROWN Com isabtijo. mission q FF 14020018 eal) -�' Expires ovem �� Tmyidn Nvuerce00W85'1019 �`�PF„fb4�• 9oiwaTnm CONTRACTOR SIGNATUW STATE OF FLORIDA COUNTY OF Broward The foregoing instrument was acknowledged before me this loth day of February 20 15 , by Richard Woodley Manning who is personally known X or has produced Signature of Commission No. identification. LJNDA C. GOSSELIN W COMMISSION N EE 224 NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR THIS BUILDING PERMIT AS AN OWNER/BUILDER, THE OWNER MUST PERSONALLY APPEAR TO SIGN THIS APPLICATION IN THE OFFICE LISTED ON THE FRONT OF THIS APPLICATION. OWNER BUILDER AFFIDAVIT WILL BE REQUIRED FOR ALL OWNER/BUILDER APPLICANTS. For specific instructions see appropriate permit checklist. ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: SCANNED Permit Number: 1506-0477 BY St. Lucie County Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERMITAPPLICATION FOR: Building PROPOSED INPROVEMENT LOCATION: Address: 3022 NW Radcliffe Way Legal Description: Riverbend Plat Book 67 Page 36 City of Port St. Lucie, St. Lucie County, Florida Property Tax ID #: 4425-703-00_ 12 -ovo - 2 Lot No. 7 Site Plan Name: Riverbend Block No. Project Name: Riverbend Setbacks Front Back: Right Side:, Left Side:,0 DETAILED DESCRIPTION OF WORK: I III New Construction-SFR of Qaulifier CONSTRUCTION INFORMATION: III onaiworKtooe HVAC Electric ertormeu unaerEmspermit-cnecKau appiy: Gas Tank ❑Gas Piping Shutters Z Windows/Doors Plumbing []Sprinklers 1:1 Generator ❑✓_ Roof 0 Total Sq. Ft of Construction: Cost of Construction: $ S Ft, of First Floor: _ Utilities:11Sewer WISeptic" Building Height: OWNER/LESSEE: CONTRACTOR: Name Standard Pacific of South Florida Name: Scott Harala Address: 825 Coral Ridge Drive Company: Standard Pacific of South FI GP, Inc. City: Coral Springs State: FL Zip Code: 33071 Fax: 954-434-8840 Phone No. 954-232-2290 Address: 825 Coral Ridge Drive City: Coral Springs State: FL Zip Code: 33071 Fax: 954-434-8840 Phone No. 954-232-2290 E-Mail: Permits@brownspermitting.com Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: Permits@brownspermitting.com State or County License: CGC1506052 It value of construction is 52500 or more, a RECORDED Notice of Commencement is required. G SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Nat Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: _ Zip: Phone: City: k State: _ Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. ' St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recordine your Notice of Commencement. Signature of Owner/ Agent/ Lessee Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF Broward The forgoing instrument was acknowledged before me this 5 day of May 20L_J by Scott Harala (Name of person acknowled (Signature of Notary blic- State of Florida ) Personally Known x Type of IdentificatRR'�--! Commission No. Revised 07/15/2014 Commission # FF 140607 Expires NdfffiSbr 4, 2018 Banded Thy Troy Fain Insurance B......IO1B STATE OF FLORIDA COUNTY OF Bmward The forgoing instrument was acknowledged before me this 5 day of May 20ZZ)by Scott Harala (Name of person acknowled Type of Notary Public -State of Florida ) OR Produced Identification wmmissbn # FF 141*81) E# tb lv vember 4, 2018 Bond Thm Troy FNn em _ —, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 1 1 COUNTY F L O •R •I .D A''- L R Planning & Development Services Building & Code Regulations Division 2300 Virginia Ave. Fort Pierce, FL 34982 (772)462-1553 Fax 462-1578 CHANGE OF CONTRACTOR Or Subcontractor or Cancellation of Permit RE C i-:- # . MAY 1 1 2016 Public Works St. Lucie County, FL Change of Contractor is to be completed by the property owner, and the new contractor of record for the current permit. A new permit application must also be completed with new contractor information, signature, and transfer fee. A new Notice of Commencement must be filed in the new contractor's Change -out). A recorded copy must be name for job values greater than $2,500 ($7,500 if A/C submitted prior to commencing any work. Subcontractor changes can be completed by the general contractor. Absent extenuating circumstances, a cancellation of permit is to be executed by both the owner and qualifier of record. Date: 5/11/16 Permit Number:—, S_0(- —C)4—n Site Address: 30 2"L u l,J��� Richard Manning Woodley Original General Contractor (or Subcontractor) State License CBCA17�_ SLC License Scott Harala New General Contractor (or Subcontractor) State License CGC1506052 SLC License Reason for Change Richard Woodley left company t ne undersigned does hereby agree to 1111 7n.1nify and hold harmless St. Lucie County, its officers, agents, and employees from all costs, fees, or damages arising from any and all claims of action for any reason, which may arise as a result of this change of contractor/subcontractor or cancellation of permit. A permit cannot be cancelled if work has been performed, SIGNATUREGFOWNER (or ownedbuildei) PRINT NAME State of Florida, County of St. Lucie County The following instr unent was acknowledged before me this 5 day of May . 20 �a , by Scott Harala , ovally know to me ovem • UeEltrFe%dNi�iit •o:�' Banded ihv , Foin Insurance 9003§'jjR� I17. a • SIGNATURE OFFNEW UbNEERAL CONTRACTOR PRINT NAME Stott Farah State of Florida, County of St. Lucie County The following instrument was acknowledged before me this —AGI—day of May 20 1s by Scott Haraa who is personally know to me or who has produce as ID. E RR�WN Signature of Notary E•L C,ommission # FF 140607 =•� _ ra; Expires November 4, 2018 y signature required for change of subcontractor . PF^'° Bonded Thm TW Fe n inane,. aaMaed019 Revised 07/21/14 sNE APPLICATION #:P.P1193314 Q STATE OF FLORIDA PERMIT #:56-SF-1613281 ~ DEPARTMENT OF HEALTH DOCUMENT #:F[1051555 ONSITE SEWAGE TREATMENT AND DISPOSAL SYSTEM .a CONSTRUCTION INSPECTION AND FINAL APPROVAL DATE PAID:06/1812015 eao ue'N"" FEE PAID:515.00 RECEIPT #:56-PID-2695841 APPLICANT: Standard Pacific Of Florida GP, Inc. AGENT: Dave Fowler (Culpepper & Terpening, Inc) PROPERTY ADDRESS: 3022 NW Radcliffe Way Port Saint Lucie, FL 34952 LOT: 7 BLOCK': SUBDIVISION: Riverbend ID#, 4425.703.0012.000-2 CHECKED [X1 ITEMS ARE NOT IN COMPLIANCE WITH STATUTE OR RULE AND MUST BE CORRECTED. TANK INSTALLATION SETBACKS [ 1 [Oil TANK SIZE [1] 2100.00 (21 :483.00 [ 1 [271 SURFACE WATER 100 FT [ 1 1021 TANK MATERIAL Concrete [ 1 [281 DITCHES FT [ 1 [031 OUTLET DEVICE [ 1 [291 PRIVATE WELLS FT [ 1 [041 MULTI -CHAMBERED 1 Y N ] [ 1 130,1 PUBLIC WELLS FT [ 1 [051 OUTLET FILTER Polylok PL-68 [ 1 [311 IRRIGATION WELLS FT [ 1 [06] LEGEND. 1. 28-015-08SC3 2.. 70-143-54SC4 ( ] 1321 POTABLE WATER -12 FT [ 1 [073 WATERTIGHT ( 1 [333 BUILDING FOUNDATIONS 9 FT [ 1 [081 LEVEL [ 1 [341 PROPERTY LINES 5 FT [ 1 [091 DEPTH TO LID [. 1 [351 OTHER FT DRAINFIELD INSTALLATION FILLED / MOUND SYSTEM [ 1 [101 AREA 113 588.64 (21 SQFT [ 1 1361 DRAINFIELD COVER [ 1 [111 DISTRIBUTION BOX _ HEADER x ( 1 (371 SHOULDERS [ 1 (121 NUMBER OF DRAINLINES 1. 4.00 .2.: [.. 1 [381 SLOPES [ 1 1131 DRAINLINE SEPARATION [ 1 T391 STABILIZATION 04/27/2016 ( 1 [141 DRAINLINE SLOPE. [ 1 [151 DEPTH OF COVER ADDITIONAL INFORMATION [ 1 [161 ELEVATION [ ABOVE / BELOW ]EM 19.00 ( 3 [401 UNOBSTRUCTED AREA [ 1 (171 SYSTEM LOCATION [ 1- [411 STORMNATERRUNOFF [ ] [is] DOSING PUMPS 1.00 (. 1 [421 ALARMS [ 1 [191 AGGREGATE SIZE [ 1 [431 MAINTENANCE AGREEMENT ( 1 [201 AGGREGATE EXCESSIVE FINES [ 1 [443 BUILDING AREA [ 1 1211 AGGREGATE DEPTH [ 1 [451 LOCATION CONFORMS WITH SITE, PLAN FILL / EXCAVATION MATERIAL E. 1 [461 FINAL SITE GRADING [ 1 [221 FILL AMOUNT [ 1 [471 CONTRACTOR Brian Davis (Brian Davis Sep [ 3 [231 PILL TEXTURE [ 1 [481 OTHER INFILTRATOR Quick4 Plus,E036 LP [ 1 [241 EXCAVATION DEPTH. ABANDONMENT [ 1 [251 AREA REPLACED [ 3 [491 TANK PUMPED [ 1 [263 REPLACEMENT MATERIAL [ ) (501. TANK CRUSHED-& FILLE➢ Comments: Convents are on page 2, CONSTRUCTION I APPROVED / DISAPPROVED ]: St.LUdle CHD HATE: 03/04/2016 Environmental Sp at Brian J Ingram (ENVIRONMENTAL.HEALTH) FINAL SYSTEM [ APPROVEO / DISAPPROVED 3; ' - St. Lucie ORD DATE: 04/27/2016 v arnmen c�a t Han ngmm TFp (Explanation of Violations on following page) DH 4016, 08/09 (Obnoletes .all previouseditions which may not be used) Incorporated: 64E-6.003, FAC Page 2 of 3 EH Database v1.0.1 AP1193314 EIDIS13291 STATE OF FLORIDA ' DEPARTMENT OF HEALTH ;ONSITE SEWAGE TREATMENT .AND DISPOSAL SYSTEM 'p CONSTRUCTION INSPECTION AND FINAL APPROVAL cso as Violation Number Com:eents APPLICATION n:AP1193314. PERMIT r1:56-SF-1.613281 DOCUMENT * A 1051555 DATE PAID:06/18/2015 FEE pxm:515.00 RECExPT f<:56-PID-2695841 The system is sized for bedrooms with a maximum occupancy of 8persons (2 per bedroom), for a total estimated flow of 460 gpd. Two single chamber 1050gal septic tanks installed in series before pump tank. Both tanks have legend number 28-015-08SC3 No violations, system ok to cover. Contractor notified cnsite. Needs final for mound system and alarms. Final system approved. Contractor and building department emailed final approval. DR 4016, 08/09 (obsoletes all previous editions which may not be used) Incorporated: 64E-6.003, FAC Page 2. of 3 EH. Database v1.0.1 AP1193314 EID1613281 /.So Y 7 7-�.a - _ "' Pre -Construction ,V YEULU11AETT Termite Treatment ' h a-lzd crviccN" 7670 Okeechobee Blvd., West Palm Beach, FI. 33411 Phone:' 1-800-285-7378 Fax: 561-684-0122 Property Information Builder/Contractor Treatment Date �' - / Time Lot 7 Black _ Name of Builder Subdivi a Nqo/ a Q Shell Contractor 3reet Address (If known) Construction Type City State zip PXfonolithic []Floating/Stemwall []Patio Owner's Name (If known) []Entry []Driveway []Other: Product/Treatment Information Treatment Type: ❑ Underslab ❑ Patio/Driveway/Entry inal ❑ Wood Treatment ❑ Bait System ❑ Other Product: ❑ Disodium Octaborate ❑ Cypermethrin Tkrridacloprid Bifenthrin ❑ Permethrin ❑ Other: Concentration i)S 'Mixed Product Applied Square Feet Treated Linear Feet Treated L1 D ®'If this box is checked, then Final Perimeter treatment has been completed and the following statement is applicable: Certificate of Compliance: This building has received a complete treatment for the prevention of subterranean termites. This treatment is in accordance with the 1 ws and rules tablished b e Florida Department of Agriculture and Consumer Services. 1z - Applicator's Name (please print) icat s gnature HES-TE019 02/14 tt Environmental Services© 2015 PLANNING AND DEVELOPMENT SERVICES DEPARTMENT Building and Code Regulations Division RECEI`"D JUN 2 6 Its BUILDING PERMIT o SUB -CONTRACTOR SUMMARY WIKwill be using the following sub -contractors for the (Company/Individual Name) project located at 3Oa.% N� (4-PLOCA address or Property Tax 16 #) It is understood that if there is any change of status regarding the participation of any of the sub -contractors listed below, I will immediately advise the Building and Zoning Department of St. Lucie County. Trade Name of Company/Contractor St. Lucie County/ State of Florida License Number Electrical G Plumbing C'�`�`jp't"� �� � CFe, 0 A97"7 HVAC/ l/Je d�t7 �`�2 e� C,0 ti 51f.o Mechanical Roofing C �� C GG 1 j 2'73a Gas OFFICE USE ONLY; PERMIT ISSUE DATE: NUMBER: Revised 07/29/2014 RECEI`.TU JUN 2 6 Ob \' ,... ' ' 3 s ni F •k4 '. ° de PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (If appiimble): CAC045860 Engineered Air have agreed to be the (Company Name/Individual Name) HVAC sub -contractor for Standard Pacific (Type of Trade) (Primary Contractor) for the project located at 3o za , KW ?0,Ac►:X,-_ (Project Street Address or Property Tax ID #) 1 It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ;GNATURE Mil.: R EQ!!iE ED Dennis A. Duff PRINT NAMEE(ATIZ Business Name: Engineered Air Address: 2520 N. Andrews Ave Ext City/State/zip: Pompano Beach FL 33064 Phone: 954-449-1600 email: chrisw engineeredairlc.com OFFICE USE ONLY: RECEI', -D jUN 2 6 WS PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: 4 C43 State of Florida Certification Number(ifapplicaft CCC1327323 CJM Roofing have agreed -to be the (CompanyName/hidividual Name) Roofing sub -contractor for Standard Pacific (Type of Trade) (Primary Contractor) for the project located at 3 t 22— N L,I (Project Street Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: sLCCDv No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED U Stephen Mallek 10/7/13 SIGNATURE PRINT NAME DATE Business Name: CJM Roofing Address: 4365 Okeechobee Blvd. City/StatelZip: WPB, FL 33409 Phone: 561-722-5988 email: tammyj, ,cjmroofing gmail.com VkECE1'7:D JUN 2 6 In PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (Irapplimble): Ridgeway Plumbing (Company Name/Individual Name) CFC019077 Plumbing sub -contractor for (Type of Trade) have agreed to be the Standard Pacific (Primary Contractor) for the project located at 3022- NW fZ�i�l� Wa i (Project Street Address or Property Tax ID #) It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED zww�:�_ Gary SIGNAT PRINT NAME Business Name: Address: City/State/Zip: Phone: Kozan Ridgeway Plumbing 640 Industrial Ave Boynton Beach, Fl 33426 561-732-3176 OFFICE USE ONLY: DATE email: kathy@ridgewayplumbing.com REC@':'C JUN 2 61016 COUNTY F L O R I D A PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number Qfepplimble): EC13004128 AC Quality Electric have agreed to be the (Company Name/Individual Name) Electrical Sub -contractor for 'Standard Pacific (Type of Trade) (Primary Contractor) for the project located at `&22 N ICJ' W�,Q-- � (Project Street Address or Property Tax ID # It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSYNESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED Gary R. Evans (ol2GICE SIGNAUJRE PRINTNAME DATE Business Name: Address: City/State/Zip: AC Quality Electric 2307 NW 115 Ave Coral Springs, F1 33065 Phone: 954-294-0101 OFFICE USE ONLY: email: almacqualityelectric.com RECEI`:'=D 1U% 2 6 0 PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION BUILDING PERMIT SUB -CONTRACTOR AGREEMENT St. Lucie County Contractor Certification Number: State of Florida Certification Number (Ieappliwble): HW Automation, Inc. (Company Name/Individual Name) EF20000457 have agreed to be the Low Voltage sub -contractor for Standard Pacific (Type of Trade) (Primary Contractor) for the project located at 3022 pow Re'olt�e W (Project Street Address or Property Tax ID #) f It is understood that, if there is any change of status regarding our participation with the above mentioned project, I will immediately advise the Building and Zoning Department of St. Lucie County by personally filing a Change of Contractor notice. (Form: SLCCDV No. 004-00) BUSINESS QUALIFIER (Name of the Individual shown on the Contractor's License) ORIGINAL SIGNATURES ARE REQUIRED IGNAT PRINT NAME DATE Business Name: Address: City/State/Zip: Phone: OFFICE USE ONLY: PERMIT # ISSUE DATE RECEI` `C JON 2 610T PLANNING & DEVELOPMENT SERVICES DEPARTMENT BUILDING & CODE REGULATIONS DIVISION 2300 VIRGINIA AVENUE FORT PIERCE, FL 34982.5652 (772)462-1553 FILLED LANDS AFFIDAVIT I, the undersigned, am the owner of the following described property, Palm City, F1 34490 (Parcel for which I have applied to St. Lucie County for a Final Development Permit. In accepting this Final Development Permit, BP Number , I acknowledge that as owner of the above described property, and in accordance with Section 7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring adequate drainage so that the immediate community WILL NOT be adversely affected. I further acknowledge that in granting this permit for the development of this property, St. Lucie County is neither obliged nor liable to provide for, or maintain in any form, adequate drainage off my property which will not adversely affect the immediate community. Michael Me kes Property Owner m (P se Print) Property Owner gnature Date t'U STATE OF FLORIDA, COUNTY OF Broward ACKNOWLEDGED BEFORE ME THIS 5 DAY OF L_ , 20 15 By Michael MetzkeS WHO IS PERSONALLY KNOWN TO ME OR WHO HAS PRODUCED AS IDENTIFICATION. COMMISSION NUMBER SLCPDSD Revised 08/24/2010 Denise Brown TYPE OR PRINT NOTARY 'e "•., DENISE BROWN Commission # FF 146MV ) �•. Expires November 4, 2018 '•.pN(1t„ BondedTwTmY Fein lnswancaBWJ&5-101A JOSEPH E. SMITH, CLERK 0- 1;.HE CIRCUIT COURT - SAINT LUC77-=17OUNTY FILE # 4097333 OR BOOK �3 PAGE 1616, Recorded 07/31/ 5 at 10:28 AM NOTICE OF COMMENCEMENT Permit No. t 506 -0411 Tax Folio No. 4425.703.0012.000-2 State of Florida County of St. Lucie The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following Information is provided in this Notice of Commencement. Legal Description of Property. (and street address if available): palm City, FL 34990 Rlverbend(PB 67-36) 3022 NW Radcliffe Way Y, General description of Improvement: New Construction—SFR and or Pool LOt7 Owner Information or Lessee Information It the Lessee cantracled for the Improvement: '— Name Standard Pacific of South Florida Address 825 Coral Ridge Drive, Coral Springs F1 33071 Interest in property: Name and address of fee simple titleholder (if different from Owner listed above): Contractor's Name: Standard Pacific of South Florida GP, Inc TLU Contractor Address: 825 Coral Ridge Drive, Coral Springs Fl 33071 Phone Number: 954-575-2524 yr= y � Surety (if applicable, a copy of the payment bond is attached): Amount of bond: $ rz� Name and address: Phone number: `C CL Z U Lender Name: Phone Number: Y Lender's address: p i:z W Persons within the State of Florida designated by Owner upon whom notices or other documents maybe served as provided by Sect!r. •a U U c_ Z 713,13(1) (a)7., Florida Statutes: w Name: Michael Metzkes Phone Number: gse-575-736t —) c� Address: 825 Coral Ridge Drive, Coral Springs R 33071 Q l ~~� In addition to himself or herself, Owner designates of to receive a copy UenD(s Notice as provided in Section 713.13(1) (b), Florida Statutes. Phone number of person or entity designated by owner: Expiration date of notice of commencement: (the expiration date may not be before the completion of construction and final payment to the contractor, but will be 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWN ER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Under penalty of *r1ufy,r Mclare that I have read the foregoing notice of commencement and that the facts stated therein are true to the best of (Signature of Owner or Lessee, or Owner's or Lessee's Authorized Officer/Director/Partner/Manager (Signatory's Tide/office) The foregoing instrument was acknowledged before me this 22 dayof June , 2015, By Michael Mat7kes as Officer for Standard Pacific of South Florida p)aa+e`of Persslij Type of authority (e.g. officer, trustee) Party on behalf of whom Instrument was executed (Signature of Notary Public - (Print, Type, or Stamp C(P commission M FF 14U5ur Expires November 4,209 a�u.[1Nulmriinw+u.nu[MJBNOi9 Personally known X or produced Identification_ Type of Identification produced RECEIV ;D SEP 0,12015 i- - ;'0 *am- 3.601-A,C.rO4rp'ads PkVVV ,Ft. Piefde, FL34945 402769076 Galebs'ulafkm INSULATION INSTALLATION CERTIBIZATE. caiAtlanoo SUBMWSIONfterband YOB AMMS; 3022 NW RaddMe Way Cm: Pah City pF,RWr.#: f SD 0 V 7 7 10TIBLOCK: 7 The un escribed Ptqpertya follows. dtisjgW hereby ceitiflOthAtinsulgion. has been his lqO in above d Rows. 3 refledve foil to a thickness of —25— MOM, which I. Exiofior.CUS walls has been nsWatea with according to Ft--campany will :yield an" V'value-of 41 Exterfur I ftamwalla has been insulated with, 'to -a thickness of — InaeO, Witichaccording tO will yield?an "R" value of, 2. ppltn to athl6kness of 12 inches: which , gs,(flatj. has ppeo insulatedwith, fiberglass baU , , - according At to, Owe6s Coming_ Will yield'an'*'-value of 38 U e . Oings tWTtedj has bemwi ulatedmiffi to a thicknessof. inches; which according,to will Y old an 'T'vaTuc of 3, Interior k nee,wallstas -bow insulated with, of which .accordingto will yield an '%V-ValMof 4. ()arage Partition walls adjacent to conditioned living.space-Wis WaInOWedVith fiberglass batt. to It thickness of 3.5 inches, which according to Owens coming 'VA11 yield an i1R11 vWAq of General Signature Of 4da&ioti 1,ieen$04 CGC1,5,1i 179 APSJULIOV WARD W COMMISSION N'FF194310 EXP14S JaMMY 29-2019 C93 day i ,TruTe6m, i!A,Crdsseoads PkWy 1310tdO, FL44945 102799075 qe. bsoulad6n BUILDER' CalAtIantho TOBADDUSS- 3022NWRadcliffe Way . INSULATI . ON INSTALLATION MTRICATE. SUlaDIVISION alverbend C.IW Palm City PBMT* L0T/BLQCX*,--L, The undersigned hereby cartifios:that insolation-hos been installed.in j4d above described Proper as fOROWS: 1. ExieflorplIS walls has beeniiiinsti lated with reflective foll to a thickness of —.76 inches, which WCOrding',W Ft -Company will',yield an:"FV! value of 4.1 IFxaerjoT frame:widls has been insulated with_to-a -thiftess of inches,, whioltacePrdingto —will yfeld='W value of, Ceilings #W).,has §ecA insulated with fibe"1852 batt . to a1hi6kness of 12 inchesI which acoortlingto- Owens coming wflt yieldan'W' value of 38 Ceilings j hasheen4rwulafedwith Which , lted to"a thickness nf,� Al ihohosi accordlng,tc, will yield an "W"valuc of. 3, Interior Imeewalls1as been insulated with ,accordingth will yield an 'W-Value"of 4. Garage Partition walls adjacent to Conditioned riving. space -has -bdenlrisutaed,with ftbemlassbatl thfoltriess of-_I._Sinches, which according to Owens Corning ,%&-yi6Id an,"R11 vaiue:of General-Con"Ivporllqkldor ooInsulattcmctuitracrto,, 81,W4ir 6 Licens000CIU2170 THEAFFIANT, Dave-Fien .IS PERSONAi�Y.KNt)WNI.OME,SWor.;I.to;andsubscribed 4qf.qremethis . 92� day bf—al Wary'Publl0,.St4t9Pf 0000A 64VLwJ- JULIE ION WARD My COMMISSION FF19431l) EXPIRES January 29. 2019 ; I mum" WWA* r 5823)873. .�A �4" PII nt: Begin. Loading; To. ob: Arrive Job; Stdlt UNoad: Fi 'is Unload; Leave Job: R® tum Pla t: Customer Code: Customer Name: Customer JobNumber. L3-,0, 1-QNIE FRUCTSQN :;L:I;'V T(.E.'. I IX, It. i'. r'i ,Sf?7U Project Code Project Name:. Project P.O. Number , L'er ;! :.xi; l fr i y., 1E¢t?+. ? }. I ,} !li�-t .vie.l1'1--,'Lt Ticket Date: DeliveryAddress: I AJ'T 7 F2 Delivery' Instructions: (4 � .� L `•,F, il I - - fi`. -., , i.r ', :`C.F;it :lL �:-IT t"_t?, "''� ^•'4Ef'i •:�f �: �t i ,'-'.j'!i. 1 `,IPJ-r V lfi"t_Cy- i 1 f 11.4 t ;111 I r ltil'.!i Order Code i Date: _Order P.O.'Number. Map Page' MaplRow/Colum Dspatcheri' c Cv4-`rlTtit.T1g , Ticket Number: Due On Job: -Slump: I Truck Number: DriverNumber. DdvenName^ End Use; - _1S? F, t t"ts 'r, i4I1Ck L.1711!f5 1F:)iF:Y DI LNG- SLA IP . QUANTITY COUAN TNE" ORDERED -PRODUCTION QUANTITY QUANTITY MATERIALCODE DESCRIPTION UOM UNIT PRICE' '•AMOUNT` } or ,}r, i vr,` r T.•)L-f n111t"f �tia';C _ ry r. 1 r, x i. h1�7j �tl'j „7i. nt (i l... „ii:l(:i IUI L',I.i 4i%.;�.A.•6jJe`- Cash - Check#f Auth Code: Signature of Driver Receiving, Cash: Cash Resolved: Tote J Check Charge Comments: WAT,ER:ADDED': GAL YARDS INDRUM: - WHEN .ADDED. CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: C taf; i 1 of t`LiI..:I. �. �IAYkRI? a .SIGNATURE ❑ LOAD WAS TESTED BY:.. Notice:. Our drivers will make every offortto place materials, where the customer designates, but the SPECIALTERMS. Any water added is at customers own risk. Ifwater is added on job, concrete sbengm• Company assumes no responsibility for damages inside am or property line. Customer agrees to the is no longecguarameed. WARNING: Product may cause skin and/or eye imtation. CAUTION: Material '.terms, of sale and delivery and acceptsconcrete as is. Due to important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important control after delivery, this Company will not accept anyresponsibility for the finished results:. No credif for ,safety handling' Information, avid to the material safety data sheets for additional information. returned cenorete. Buyers exceptions and claims shallbe deemed waived unless madeto us in writing. AUTHORIZED SIGNATURE' within one business day after the receipt of materials. ® /b 68UNIVERSAL rt.R I' V VIRK lt;tE;k�'; .y :J�F LOAD NLJrl,. CUSTOMER' This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Terms and Conditions', Seller's Qui m, if any, and Seller's Order Confirmati ncluding limitations of warranties) set forth on this Delivery Ticket CV :ment"). Seller will provide the Standard ns and Conditions upon request. that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expres< pay in accordance with the Agreement. AGGREGATE/CEMENT/ PRODUCTS / FLY ASH Aggregate products are naturally occurring materials including limes] >ne, dolomite, granite, volcanic rock, sand, gravel siliceous materials. Cement products include Portland cement, matyMnry, pozzolan (Type IP), roof tile, and stucco, products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sandal other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica. \\\ Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or burns of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure. Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection. First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh air. If wr.t cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combined Houston, Texas 77024 02/12 For more information please visit www.cemexusa com. Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en sit aplicaci6n de cr6dito); cualquier termino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y gararttias), Como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveerd los t6rminos estandares y condiciones detal- lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que las cantidades y materiales fueron entregados como se expresa en el mismo. Acepta pagar cl montode acuerdo al contrcto; al menos que se identi- fique con una nota al frente de este documento. /PRODUCTOSDE ILC01►1VA0.9 Los productos de agregados son materiales naturaley como piedra caliza, dolomita, granito, coca volcanica, arena, grava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados come piedra caliza, dolomita, granito, roca volcanica, arena, grava, y otros materiales silicios: Estos productos incluyen cenizas volantes (fly ash) la cual puede contener m'as de 0.025% de silicio cristalino. "eligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y ojos, y reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel y/o en la zona respiratoria. Polvo del manejo en el trituramiento, pulido, cone y/o perforaci6n puede contener materiales silicon, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingeridos, mantenerse en temperatura c5lida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoniaco. Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalacitin del amoniaco puede causar toser, irritaci6n o quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. Ell riesgo en la salud depende en la duraci6n y el nivcl de la exposici6n. Seguridad: Evite el contacto con ojos y contacto prolongado con la piel. Use guantes, protecci6n en los ojos y ropa Primeros adecuada para protecci6n. Lavese las manos con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a pelves mds de los limites recomendados, use protecci6n respiratoria. Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la parte afectada por 15 minutes. Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a Tondo con agua. Acuda a atenci6n medcca immediatamente si la irritaci6n continua. CEMEX, Memorial Hermann Tower 929 Gessner; Suite 1900 V7 combinado Houston, Texas 77024 02/12 Para mas informaci6n visita www cemexusa.com. U, r' `._rr amax 54e-.140 "MI-W 66267116 Gusto erpdde: ^tea, )c 'L}dr cus�o��er�lam ;ON:i>T'f�1J�'T1.CJN sFti'Fdl}:C(:.)EiS 'LI_G • astomgY�go`hlufnp Jn,3<� 11mG J�/Data: 12i CC.I1.`7 Prele ode %t�t7h 5:9 ..: ,, ,... .. .. ,. ' arelf�l( �M?afdFZR1. T{1[Z'U' V f O P°'at3L)° T960,4TF7t'D` ....,. 'S i`o a�P4° r° } Ticket'ate; ._�_ I� ,:2 15 Deli a ress �%S�°—/, R•J.,t1LFtHEP•iJ) Map Page:. 'Map/Row/Column: i Delilyl °l.r�t•a,% < 7 ,.T , �a i '• L..fri 3� �. . f5. 5 :.i'iF u :' `rr t r;5 �ai �cf •NiF •1 c. t' a y,l: Dlspat5har �tt11 �. n g;' � �, i Ticket Number: !� Duepn ob:4f, Slump: Truc11,i4Sn�er:'iac:�t Driv�rlJNglgel:l. `i DriveMmi_ C3TRAE1S i End Use: �t.E.aNEit Wr1L LOAD QUANTITY CUMULATIVE QUANTITY ORDERED MATERIAL CODE QUANTITY PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT 9 I)t) 1 E1 i70 ? iii 1 ;7 ?t85 3 fit} [ VIG " Y jV .. . • , r t l 'N i ..r y'i r1 1 � ?•] Y t `Sly. ..ir, i I i�.. ."� OV ' L 47IS11 FUEL_ I. SLJRCIAARI3L-' 1 nI) .n j z 1i�62749 EIJVIRONMENTAL CtAARGE a . 1 1h Qli ° y'�ius < ' [[ • .. `I';�i� Cash Check It IAuth Code: Signature of Driver Receiving Cash: Cash Received: Total COD Order Amount to Collect I Without Standby Charges: I Check Comments: b I WATERADDED: GAL YARDS IN DRUM: WHEN ADDED. CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: GCit If;fiL'I''': E)'!_'iit; f,1 G1L. FEE; PAPT.IAL. t Ijl...L. I._OAD YARDIS SIGNATURE ElLOAD WAS TESTED BY: Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers own risk. If water Is added on lob• concrete strength Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye illusion. CAUTION: Material terms of sale and delivery and.accepta concrete as Is. Due to Important faclors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important control after delivery, this Company will not accept any responsibility for the finished resul6. No credit for safety handling Information, and to the material safety data sheets for additional information. returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE: within one business day after the receipt of materials. I 6 6BUNIVERSAL F''RFTY FRK: 1.01DE;2607 '- L.tIAD MUM: PLANT A -A. CEMEX . 9-H710 Rant. Beg' oaliing. To Job: Arrl .e Joti: Sta U to ? 6tDlsti Untoad-: eave o Ret, m P a is - CustoynersCOGe: -�_, Custo er amp: - i Custo er Job umbel SERVI:CG,r-.?.- tC_C . +ya2.—1/5090'- Prol PO N'b r itn6asab,• {(j M(i§ SN Tt1RLl VERCI ;'V P1L11R1 D Tlckei?'.a papelive��A dre¢ r , " t> Order Code �/.Data: Map Page:: Map/Row/Column: Dispute inn"ing _1 Ticket Number. 3'I'116071. Due6z� cfauo Slump: Ei. 0i} TmrJf, �Yt"pec _Erg/•� DdvirEnd UsC?rr�¢gr�. ;. Drivatme�r)l� C'.i�+I( r.'it..nrtG: WAL. L 0 LOAD OUANTITy CUMULATIVE QUANTITY ORDERED QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT Ct 1. 33.01 1577,B4 5 goo cl CMG Yn� 1131 ;DEC 22 ate 7io25 i7 ,r . 7. �.. 1 00 Aisyv7t 18 I UM SURCHARGE +• k r`r '1 Ot) • xr � �'� �" � 1rt1r.,!'�1�1.f'.hIV1FiQNh1E�17111 'f'f"IAF3GC i„` `�•;�� +.�: * wk Y r. Cash Check N/Auth Code: Signature of Driver ReceiJin Cash: 9 , 9 ' - `' e ' , ' " Cash Received: ` Total COD OiCer Amount to Collect Check Without Standby Charges: Comments: CONIC RI'_:1'i,': OfOi' OSI-V... PEE _ I='f-1Rl' 1AL. r-[.ILL LOAD Y61Rn WATERADDED: GAL YARDS IN DRUM: WHEN ADDED. CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: I O LOAD WAS TESTED BY: SIGNATURE Notice: Our drivers will make every effort to place materials where the customer designates, but the- SPECIAL TERMS: Any water added Is at customers own risk. If water is added on Job, concrete strength Company assumes no responsibility for damages Inside curb or property line. Customer agrees to the Is no longer guaranteed. WARNING: Product may cause skin and/or eye Intl CAUTION: Material terms of sale and call and accepts concrete as is. Due to Important factors which are aut oM1our may ba haTardous to your safety and health. Please refer to the backside of this ticket for Important control after delivery. this Company will not accept any responsibility for the finished results. No credit for safety handling information, and to the material safety data sheets for additional Information, returned concrete. Buyers exceptions and claims shell be deemed waived unless made to us In writing AUTHORIZED SIGNATURE: within one business day after the receipt of materials. 68UNIVERSAL PREV ) RK,— WAD Null 1 PLANT bftcmcx 58230877 og77 .: Plant: Begin Loading: To Job: Arrive Job: Start Unloadi'. Finish Unload: Leave Job: Return Plant: o" l7 rIICir o Customer Code: Customer Name: Customer' Job Number: Order Code Date: ::V2'clr:35 UST `—ONSTRUC1�10N SEP.VIC'ES LLC 442/7/3070' 511 i2/08/15 iPmject Code:Project Name: Project P.O, Number: Order P.O., Number: "0'i,110 ;g6yi'-;�IfaTT' "1 Ti4M.6 lti.i'O PO REQIJIRI:A) /442/7,13070 Ticket Date; Delivery Address: .Map Pager Map/RmIColumn: 1'/CIS IS .C]'I'' I9 R1VERBE'ND Delivery Instructions: 'Dispatcher: ` i'?�i«". C�171f CaF�nYlin .'l..JT-NPf.j'E. NORTH rca BE.e..14UR ROAD EAST, Ticket Number. E:fT' t)iE Sxr_t:t#E.r? RonD.; Piaiir oN-jurtl>ERGS0UT 1..f4NE; !N"i"U CONSTRUCTION, E:NTE2ANCE 34179o209 Due On Job: Slump: - TmckNumber: Driver Number. Driver Name: - 4 End Us . 08a71 5.00 1]Clcr'Et]7 JUc:3 log VIE7TS]R CRUZ PLDRIG: SLAB LOAD CUMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM )UNITPRICE AMOUNT QUANTITY QUANTITY QUANTITY J 0. to t'400 E1Ci. ;:fS ,'5 7GE ;=500 RE'G rD 1 , t7rti 1 "14"M113 FUU.1 3UR1,14OR]E . ;:-027 a LNV%RONMENrAIL I"FJ(-aRGE Code: Check DEC V, *18:30 to WATER ADDED:GAL YARDS IN DRUM: / " WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: CONCRETE DISPOSAL FEE SIGNATURE G'r-�rTzAE_ ___ FUE_L_ LOAD _ YARDSi ❑LOAD WAS TESTED BY ' at� Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIALTERMS: Anywateraddad- sustomer own sk. if water is added on job, concrete strength Company assumes_ no responsibility for damages inside curb or property line.: Customer agrees to the is no longer guaranteed WARNING: rProduct mPauso7kyland/or eye igitation. CAUTION; Material terms of sale and delivery and accepts concrete as is, Due to important factors which are out of our may be hazardous to your safetyiantl jE�allh. PI ase kfer t0 the backside of this ticket for Important control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handling information, and to in material eef try ta'sheeI for did tibT receipt at information, returned. concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED within one business day after the rept of materials. AU 68UNIVERSAL GREV rRK-,- loO2575G INVOICE1 L7_AD MUM: 8 This Delivery Ticket incorporates herein by reference Buyer's previous),,--ecuted Credit Application, if any, Seller's Standard Terms and Conditions, Selli quotation, if any, and Seller's Order Con rtion (including limitations of warranties), as if fully set forth on this Delivery Ti, ("Agreement"). Seller will provide the St_......rd Terms and Conditions upon request. Buyer agrees that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to pay in accordance with the Agreement. AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or bums of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure. Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to dust above recommended limits (see MSDS), wear suitable MOSH-approved.respiratory protection. First Aid: In case of eye contact, immediately flush eyes with flowing water for 1.5 minutes. If dust is inhaled, move to fresh air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists. CEMEX, Memorial Hermann Tower 929 Gessner. Suite 1900 V7 combined Houston, Texas 77024 02112 For more, information please visit www.cemexusaxom. Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada on su aplicaci6n de cr6dito); cualquier t6rmino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveera los t6rminos estandares y condiciones detal- lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que las cantidades y materiales fueron entregados como soexpresa en el mismo. Acepta pagar el monto de acuerdo at contacto; at metros que se identi- fique con una rota al frente de este documento. AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rota volcanica, arena, Brava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulcjo de azotea y estuco. Los productos de conereto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito, rocs volcanica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) In cual puede contener rods de 0.025%, de silicio cristalino. Peligros: Mezela de cemento fresco y/o cenizas volantes pueden causar irritaciOn en los ojos, quemaduras en piel y ojos, y reacciones al6rgicas en la piel. Concreto seco y polvo de agregados. pueden causar irritaci6n en los ojos, piel y/o on la zona respiratoria. Polvo del manejo en el trituramiento, pulido, corte y/o perforaci6n puede contener materiales silicos, Jos cuales pueden causar silicosis pulmonar y edncer si son inhalados. En caso de set ingeridos, mantenerse on temperatura edlida, reposar y tomar grandes cantidades de agua. Las cenizas volamcs pueden contener amoniaco. Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o quemaduras on la nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo on ]a salud depende en la duraci6n y cl nivel de la exposici6n. Seguridad: Evite el contacto con ojos y contacto prolongado con la pie]. Use guantes, protection on los ojos y ropa Primeros adecuada para protecci6n, Ldvese las manor con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar auxilios: polvos. Si se expone a polvos rods de los lintites recomendados, use protecci6n respiratoria. Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la pane afectada por 15 minutos. Si so inhala polvo, exp6ngase a wire fresco. Si el cemento fresco tiene contacto con sus ojos, ldvelos a fordo con agua. Acuda a atenci6n m6dica inmediatamente, si la irritaci6n continua. CEMEX. Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston, Texas 77024 02/12 Para rods information visita www.ce Z,1r- cc �mx 58230881 Plant; I Begin Loading: - To Job: Arrive Job: -Start Unload: I Finish Unload: '.I Leave Job: Return Plant: ('49t, I I09( Customer Code: Customer Name: 'l�r'%:C':15 IJ'3 r r.'ONSTRUCT rON `CERVMES LLC Project Code: Project Name: _`,,On MOT -11nA z I 1 N Ti-1R1) vEF f_) Ticket Dale: Delivery Address: 1c'!08/;.r3 L_CJT- 7, R1VERSEND Delivery instructions: i'!-1L ! + T + OPITH TO DEC'EH itn,V) FAST; I_=-f-T rpd rAFC, T-R :,i�c�!), RiG'!'f ON TURNABOUT I.PK_ i,� -11 Ci.l r:;Tl.'JL;T'I Ufa Customer Job Number. Order Code / Data: /lir''!7/3o70 5! i 12/08/15 Project P.O. Number. Order P.O. Number. Map Page: Map/Row/Column: Dispatcher. G!"ar',. Ticket Number: 3-'+ocZ)Z72 Due On Job: Slump: Truck Number. Driver Number: Diner Name: End Use: 10;c8 5.,00 100234A3 ]C19U13 SILL STRAUSS PLDNGc SL_RB' LOAD...._ QUANTITY CUMULATQUANTITYIVE ORDEREDOUANTITY MATERIAL CODE PRODUCTION DESCRIPTION 'UOM UNIT PRICE AMOUNT b d r 1hJ+.�`ie J{J tl r-' ^ S 25 -- �i. �'1 _1..i7F GJ. c.JCI(7 RE=G 1.ok) IP f'7218 FUEi_ SURCHARGE 1.00 1:_t;!'.'f4" ENV[BONY*iENTAI._ CHARGE DEC1a;l9:10 Cash Check#./Auth Code: Signature of Dover Receiving Cash:. Cash Received: Total COD Order Amountto Collect Without Standby Charges: Check - Charge WATER YARDS IN DRUM: WHEN ADDED. CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: CONCRETE DI SPOSAI_ FEE PARTIAL FULL LOAD _ WARDS ❑ LOAD WAS TESTED BY: Notice: Our driveys will make every effort to placematerials where the customer designates, but the SPECIAL TERMS: Any water added is at customers own fit' Company: assumes no responsibility for damages inside curb or property. line. Customer agrees to the is no longer guaranteed.. WARNING: Product may cause skin terms of sale and delivery and accepts concrete as Is. Due to Important factors which are out of our may be hazardous to your safety and health. Please refer t control after delivery, this Company will net accept any responsibility for the finished results.. No credit for safety handling Information, and to the material safety data sheet returned. concrete:' Buyers ezceptlons'antl claims shall be deemed waived unless made to us in writing .AUTHORIZED SIGNATURE: within one busiriess dayaftepthe receipt of materials. � SIGNATURE k�f water is added onjob, concrete strength rri�d/or eye irritation., CAUTION: Material 0 1hh,ttacksid",this ticket for important '68UNIVERSAL PRE:V TRK. 1O(0) :.=:607 INVOICE L� LOAD NUM° 9 This Delivery Ticket incorporates herein by reference Buyer's previously executed Credit Application, if any, Seller's Standard Terms and Conditions, Seller's Quotati f any, and Seller's Order Confirmation ( ding limitations of warranties), as if fully set forth on this Delivery Ticket ("Agre it"). Seller will provide the Standard Ter nd Conditions upon request. Buyer agrees that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to pay in accordance with the Agreement. AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY ASH Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica. Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye burns and allergic skin reactions. Dry concrete and aggregate dust may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling, crushing, grinding, cutting and/or drilling may contain silica, which may cause silicosis and cancer if inhaled. If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo- nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation or burns of the nose, throat and lungs. See physician. Health risk depends on duration and level of exposure. Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection. First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combined Houston, Texas 77024 02/12 For more information please visit www.ccmexusa.com. Este ticket de entrega incluye comp referencia al comprador (ya previamente ejecutada.en su aplicaci6n de cr6dito): cualquier tdi•mino estandar, condiciones del vendedor, propuestas del vendedor y orden de confirmacidn del vendedor (con limitaciones y garantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveer'a los t6rminos estdndares y condiciones detal- lados ell caso de asf ser requeridos. Con este documento, el comprador acepta Ins mismos ya antes mencionados y que las cantidades y materiales fueron entregados como se expresa en el mismo. Acepta pagar el monto de acuerdo al contrato; al menos que se identi- fique con una nota al frente de este documento. AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO / CENIZAS VOLANTES Los productos de agregados son materiales naturales como piedra caliza, dolomita, granito, rota volcanica, arena, grava y otros materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albanilerfa, pozzolan (tipo IP), azulejo de azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita, granito, rota volcdnica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede contener m'as de 0.025% de silicio cristalino. Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y ojos, y reacciones alergicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel y/o en In zona respiratoria. Polvo del manejo en el trituramiento, pulido, torte y/o perforaci6n puede contener materiales silicos, los cuales pueden causar silicosis pulmonar y cancer si son inhalados. En caso de ser ingetidos, mantenerse. en temperatura calida, reposary tomar grandes cantidades deagua. Las cenizas volantes pueden contener amoniaco. Seguridad: La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar loser, irritaci6n o quemaduras en la nariz, garganta y pulmones. Acudir inmediatamente al medico. El riesgo en la salud depende en la duraci6n y el nivel de In exposici6n. Seguridad: Evite el contacto con ojos y contacto prolongado con la pie]. Use guantes, protecci6n en Ins ojos y ropa Primeros adecuada para protecci6n. Livese las manos con jab6n suave y agua despu6s del manejo de materiales. Evite inhalar auxilios: polvos. Si se expose a polvos rinds de los limites recomendados, use protecci6n respiratoria. Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en la pare afectada por 15 minutos. Si se inhala polvo, exp6ngase a sire fresco. Si el cemento fresco tiene contacto con sus ojos, lavelos a fondo con agua. Acuda a atenci6n m6dica inmediatamente si la irritaci6n continda. CEMEX, Memorial Hermann Tower 929 Gessner, Suite 1900 V7 combinado Houston, Texas 77024 02/12 Para mas informaci6n visita www.ce Pre -Construction r� R Termite Treatment 7 ' uvvaruvm¢»(vl svrvlrcc 7670 Okeechobee Blvd., West Palm Beach, 'Fl. 33411. Phone: 1-800-285-7378 Fax: 561-684-0122 Property Information Treatment Date / V111 S Time / a a Lot Block Subdivision idivision Name JG2.�G,C l Street Address (If known) city State: Zip Owner's Name (If known) Builder/Contractor of Builder Shell Contractor Construction Type []'Monolithic []Floating/Stemwall []Patio OEntry []Driveway []Other: Product/Treatment Information Treatment Type: �nderslab ❑ Wood Treatment Product: O Disodium Octaborate'' [31midacloprid 11 ❑'P,ermethrin Concentration Square Feet Treated V3 a 8 ❑ Patio/Driveway/Entry ❑,Bait System ❑ Cypermethrin ❑ Bifenthrin ❑ Other: _ ❑ Final ❑ Other Mixed Product Applied '/33 4 � l Linear Feet Treated' ❑ If this box is checked, then Final*Perimeter treatment has been completed and the following statement is applicable: Certificate of Compliance: This building has received a complete treatment for the prevention of subterranean termites. This treatment is in accordance with the laws and rules established by the Florida Department of /Agriculture and Consumer Services. Applicator's Name (please print) App 1 tor's Signature HES-TE019 02114 Hulett Environmental Services®'2614 I.SO&— ®`f 77 Soil Nuclear Gauge Client: Project: Report Date: 11/25/2015 Standard Pacific Homes, South Florida 13-0183.00 yFea. ap Test Method: ASTM D 6938 Riverbend Port St Lucie St. Lucie County, Florida FBPE CA 94930 521 NW Enterprise Dn. Port St. Lude, FL 34986 , Phone: Tr2-92435751 F= 772-9243580 Test Results Test# Retest Of Test Date ProctorlD Method Soil Classification Optimum Moisture (%) Maximum Dry Density (pcf) In Place Moisture N In Place Dry Density (pcf) Probe Depth (in) Percent Compaction Min/Max Comp. N Remark 16 10/5/15 P-2 NIA 13.0 106.0 12.5 101.7 12 96 951105 Pass 17 10/5/15 P-2 NIA 13.0 106.0 13.3 101.0 12 95 951105 Pass 18 10/5/15 P-2 N/A 13.0 106.0 12.1 101.2 12 95 95/105 Pass Test Information Test # Test Location Elevation Reference Gauge Make / Model / SN Field Technician 16 Below Slab Grade: Lot No. 7, Foundation Pad, Northeast Comer 0-1 Troxler T3430 22260 Rivera, Angel 17 Below Slab Grade: Lot No. 7, Foundation Pad, Center Area 0-1 Troxler T3430 22260 Rivera, Angel 18 Below Slab Grade: Lot No. 7, Foundation Pad, Southeast Area 0 - 1 Troxler T3430 22260 Rivera, Angel Remarks Comments Related Tests Pass: Tests results comply with specifications Tests are "Direct Transmission" (Method A) unless probe depth Is noted as "Backscatter. Gauge calibration data on file with the testing agency. 16, 17, 18: 1 - 2 HCP=70+, > 95 % Compaction, PASS. HCP tests are empirically correlated to the relative density of the soil. Test # I Related Test # Test Type Test Reports shall not be reproduced, except in full, without the written approval of GFA International Inc. Page 1 of 1